Short-Term Psychodynamic Psychotherapy (STPP) for Obsessive-Compulsive Disorder (OCD): The Hybrid Case of "Serena"

Obsessive-compulsive disorder (OCD) is a chronic incapacitating mental health condition that is underrepresented in clinical treatment settings. The worldwide treatment gap for OCD is estimated at 60% (Kohn et al., 2004), a figure that reflects a shortage of specialized services, delayed help-seeking in suffers, and a mounting cost to society. The treatment of choice for OCD is a combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRIs), which has been proven efficacious in measurably reducing symptoms to below the clinical threshold (McKay et al., 2015). Nevertheless, when evaluated holistically, the success rate of the first-line treatment is limited. This study provides a literature review of the various psychodynamic models of obsessive-compulsive pathology and their attendant approaches to treatment. At present, empirical evidence for psychodynamic therapies for OCD is lacking (Leichsenring et al., 2015).

To fill this gap in the research, this pragmatic case study (PCS; Fishman, 1999) aims to demonstrate the viability of short-term psychodynamic psychotherapy (STPP) as an effective treatment for OCD. Specifically, this pilot case study examines the theoretical implementation of Leichsenring and Steinert’s (2017) empirically-derived, manual-guided STPP treatment for OCD, rendered as a treatment for “Serena,” a 28-year-old female patient presenting with mild-to-moderate symptoms of OCD. Serena is a hybrid case, which is an aggregate of actual, de-identified psychotherapy cases and clinical examples from the relevant psychological literature. Through a disciplined inquiry approach, Serena’s treatment process is systematically described. Treatment outcomes are analyzed both qualitatively and quantitatively. This case study attempts to illustrate the interplay between symptom expression and the not-always-linear progress toward structural change. I conclude with a discussion of the applications and limitations of the hybrid case study and STPP for OCD, as well as implications for psychotherapy integration.